Papers - Tanaka, Mamoru

Thrombomodulin improves maternal and fetal conditions in an experimental pre-eclampsia rat model

Shin Mihwa, Hino Hirofumi, Tamura Midori, Ishizuka Bunpei, Tanaka Mamoru, Suzuki Nao, Tateda Takeshi

Journal of Obstetrics and Gynaecology Research 40 ( 5 ) 1226 - 1234 2014

ISSN  1341-8076

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<p>Aim: The aim of this study was to investigate whether the consecutive administration of recombinant thrombomodulin (r-TM) for 4 days improves maternal and fetal conditions and physiological outcomes in an N'-nitro-L-arginine- methyl ester hydrochloride-induced and low-dose endotoxin-induced pre-eclampsia (PE). Methods: r-TM or saline was administrated i.v. to normal pregnant and experimental PE rats for 4 days. The maternal condition, vascular endothelial growth factor receptor-1 (VEGFR-1), fetal conditions, uteroplacental blood flow (UPBF), and oxygenation in the placenta and fetal brain was evaluated on gestational day 21. Results: Significant increases in the mean arterial blood pressure, VEGFR-1 values and fetal death rate were observed in PE rats compared with control rats, while maternal and fetal bodyweight and fetal brain weight were substantially lower. Hypoperfusion and hypo-oxygenation in both the placenta and fetal brain tissues occurred in PE rats. Although r-TM failed to improve hypertension and affect the differences in maternal bodyweight between the groups, r-TM significantly improved hypoperfusion and fetal and maternal conditions, including VEGFR-1 values (6.5 ± 4.0 vs 2.2 ± 2.7 ng/mL, PE vs PE with r-TM, respectively; P &lt; 0.05). Although not significant, a decrease in the fetal death rate was observed in PE rats administrated r-TM (36.1 ± 17.6% vs 25.0 ± 23.8%, P = 0.077). Conclusion: The severe reductions in the UPBF and the placental oxygenation imply that regional hypoperfusion occurs in association with systemic mean arterial pressure. r-TM may be a candidate medical treatment for PE complications. © 2014 Japan Society of Obstetrics and Gynecology.</p>

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N-Butyl Cyanoacrylate Is Very Effective for Massive Haemorrhage during the Perinatal Period

Igarashi Suguru, Izuchi Shinichirou, Ogawa Yukihisa, Yoshimathu Misako, Takizawa Kenji, Nakajima Yasuo, Tanaka Mamoru, Ishizuka Bunpei, Suzuki Nao

PLoS ONE 8 ( 10 )  2013.10

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<p>Objective:The liquid embolic agent n-butyl cyanoacrylate (NBCA) is a tissue adhesive used as an immediate and permanent embolic agent when mixed with oil-based contrast medium. In this study, the preservation of fertility with TAE using NBCA for massive haemorrhage during pregnancy or the peripartum period and the utility of this therapy were investigated.Methods:Cases from January 2005 to October 2010 in which TAE was performed for massive haemorrhage in pregnant women, particularly during the peripartum period, were investigated.Results:TAE was performed in 27 pregnant women. The embolic agent used was GS only in five cases, NBCA only in 19 cases, and additional embolization with NBCA when the effect with GS was insufficient in three cases, one each of abruptio placentae, cervical pregnancy, and uterine atony.A comparison of mean blood loss when each embolic agent was used for haemostasis showed a significant difference between cases in which GS only was used and cases in which NBCA only was used. In a comparison of mean transfusion volume, a significant difference was seen between cases in which both GS and NBCA were used and cases in which NBCA only was used. In a postoperative follow-up survey, menses resumed in eight patients, including four patients who later became pregnant and three who delivered.Conclusions:TAE with NBCA, which has an embolic effect unrelated to clotting dysfunction for massive haemorrhage during the peripartum period, is a minimally invasive and very effective treatment method for patients with severe DIC. © 2013 Igarashi et al.</p>

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Comparison of the right and left ventricular performance during the fetal development using velocity vector imaging

Kim Seon Hye, Miyakoshi Kei, Kadohira Ikuko, Tanaka Mamoru, Minegishi Kazuhiro, Matsumoto Tadashi, Yoshimura Yasunori

Early Human Development 89 ( 9 ) 675 - 681 2013.09

ISSN  0378-3782

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<p>Background: Studies on myocardial characteristics examined by speckle-tracking echocardiography are limited. Aims: To compare myocardial performance between the right and left ventricles during the fetal development using velocity vector imaging (VVI). Subjects and study design: Echocardiograms of 95 uncomplicated singleton fetuses (19-36. weeks pregnancy) were retrospectively analyzed by VVI to measure global longitudinal peak velocity, strain, and strain rate of both the right ventricle (RV) and left ventricle (LV). The regional values were calculated for three segments (base, mid, and apex) of the ventricular free wall and segment. Outcome measures: The VVI-derived measurements were examined for gestational age and compared between ventricles. Results: The global peak systolic and diastolic velocity values of both ventricles significantly increased over gestation examined, whereas the global systolic strain and strain rate were stable (RV: strain -. 22.6. ±5.0%, strain rate -. 2.6. ±. 0.7/s; LV: strain -. 21.5. ±. 5.6%, strain rate -. 2.5. ±. 0.7/s). Compared to the LV, the RV showed significantly higher global velocity in systole and diastole (P =0.001 for systole, P&lt;. 0.001 for diastole). The global systolic velocity of the LV increased close to the RV toward term, whereas the RV was dominant in diastole throughout the examined gestation. Basal strain and strain rate in the RV were significantly greater than that of the LV, although there were no significant differences in the middle and apical values between ventricles. Conclusion: Our findings suggest the RV predominance of longitudinal contraction and dilatation, compared to the LV in uncomplicated fetuses. © 2013 Elsevier Ltd.</p>

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Reproductive and obstetric outcomes after radical abdominal trachelectomy for early-stage cervical cancer in a series of 31 pregnancies.

Nishio Hiroshi, Fujii Takuma, Sugiyama Juri, Kuji Naoaki, Tanaka Mamoru, Hamatani Toshio, Miyakoshi Kei, Minegishi Kazuhiro, Tsuda Hiroshi, Iwata Takashi, Tanaka Kyoko, Fukuchi Takeshi, Takehara Yuji, Yoshimura Yasunori, Aoki Daisuke

Human reproduction (Oxford, England) 28 ( 7 ) 1793 - 1798 2013.07

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<p>What are the reproductive and obstetric outcomes in patients undergoing radical abdominal trachelectomy (RAT) for early-stage cervical cancer? When RAT was performed before a pregnancy achieved with fertility treatments, pregnancy rate of 36.2% was obtained and 71.4% of these women gave birth at ≥ 32 weeks of gestation. Reproductive and obstetric outcomes after radical vaginal trachelectomy (RVT) are well documented; however, these outcomes after RAT have not been well studied. This is a retrospective cohort study of patients at a single institution who underwent RAT and became pregnant. Reproductive and obstetric outcomes of 114 patients who had undergone RAT from September 2002 to December 2010 were investigated. Women of reproductive age with early-stage cervical cancer who wished to preserve their fertility were documented. Patients' median age was 33 years (25-40 years). A total of 31 pregnancies were achieved in 25 patients and 6 patients had 2 pregnancies. Eighteen of 25 patients (72.0%) had infertility problems; 17 patients conceived with IVF-embryo transfer and 1 patient with intrauterine insemination. The pregnancy rate among patients who wished to conceive was 36.2% (25/69). Among 31 pregnancies in 25 patients, 4 patients had first trimester miscarriage and 1 patient had second trimester miscarriage. Excluding the five patients who miscarried and the five ongoing pregnancies, all the 21 patients had deliveries by Cesarean section. Four patients had a preterm birth in the second trimester and 17 patients delivered in the third trimester. Of the 17 pregnancies that reached the third trimester, 2 (11.8%) were preterm births between 29 and 32 weeks, 11 (64.7%) were delivered between 32 and 37 weeks and 4 (23.5%) at ≥ 37 weeks of gestation. Because of the retrospective data collection, not all pregnancies may have been recorded. Prospective multicenter studies are needed to determine if the results shown in this retrospective cohort can be generalized to all patients with early-stage cervical cancer who wish to undergo the fertility-sparing RAT procedure.</p>

Early second-trimester diagnosis of body stalk anomaly by fetal magnetic resonance imaging

Higuchi Takayuki, Sato Hiroaki, Iida Miho, Kim Seon Hye, Narimatsu Yoshiaki, Tanaka Mamoru

Japanese Journal of Radiology 31 ( 4 ) 289 - 292 2013.04

ISSN  1867-1071

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<p>We report a case of body stalk anomaly detected prenatally by fetal magnetic resonance imaging (MRI) at 14 weeks' gestation. A 29-year-old woman was followed during her first pregnancy. At 11-12 weeks' gestation, our sonographic images showed multiple fetal deformities. An abdominal wall defect was suspected. The exteriorized abdominal contents and the lower limb appeared within the extraembryonic celom with an intact amniotic membrane. Fetal MRI at 14 weeks' gestation confirmed a large anterior wall defect with herniation of the liver and bowel. In addition, abnormally rotated lower limb and scoliosis could be demonstrated. The fetus was prenatally diagnosed with body stalk anomaly, expected to be lethal in nature. The parents decided to terminate the pregnancy at 15 weeks' gestation. Prenatal diagnosis of body stalk anomaly is usually based on sonographic findings. As far as we are aware, this is the first case report of body stalk anomaly satisfactorily diagnosed by fetal MRI in the early second trimester. Fetal MRI scans should provide ground for a precise antenatal diagnosis of body stalk anomaly from early gestation. © 2013 Japan Radiological Society.</p>

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Abnormal first-trimester fetal nuchal translucency and amniotic band syndrome

Higuchi Takayuki, Tanaka Mamoru, Kuroda Keiko, Yabuno Akira, Kim Seon Hye, Asai Satoshi, Iwata Sokichi, Miyakoshi Kei

Journal of Medical Ultrasonics 39 ( 3 ) 177 - 180 2012.07

ISSN  1346-4523

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<p>We report a case of amniotic band syndrome diagnosed prenatally by serial sonographic examinations. Our initial sonographic image showed a large fetal nuchal translucency (NT) at 12 weeks' gestation. Repeated fetal ultrasound images revealed an amniotic band and right upper limb anomaly. Fetal MRI at 19 weeks' gestation revealed right forearm hypoplasia and pseudosyndactyly. The fetus was prenatally diagnosed with amniotic band syndrome and was suspected of having severe functional impairment of the deformed limb. The parents decided to terminate the pregnancy at 21 weeks' gestation. In fetuses with aneuploidy and various structural and genetic abnormalities, the NT thickness is increased in the first trimester. As far as we are aware, this is the first case report of increased NT and limb anomaly associated with amniotic band syndrome. In chromosomally normal fetuses with increased NT, intensive sonographic follow-up should provide grounds for a precise antenatal diagnosis. © The Japan Society of Ultrasonics in Medicine 2012.</p>

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Antepartum oral disposition index as a predictor of glucose intolerance postpartum

Saisho Yoshifumi, Miyakoshi Kei, Tanaka Mamoru, Matsumoto Tadashi, Minegishi Kazuhiro, Yoshimura Yasunori, Itoh Hiroshi

Diabetes Care 35 ( 4 )  2012.04

ISSN  0149-5992

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Retrospective evaluation of intravenous fentanyl patient-controlled analgesia during labor

Hosokawa Yuki, Miyakoshi Kei, Morisaki Hiroshi, Tanaka Mamoru, Nakatsuka Itsuo, Yoshimura Yasunori, Hashiguchi Saori, Takeda Junzo

Journal of Anesthesia 26 ( 2 ) 219 - 224 2012.04

ISSN  0913-8668

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<p>Purpose Because the safety of intravenous fentanyl patient-controlled analgesia (iv-PCA) administered during labor remains unclear, we retrospectively examined the labor records from January 2005 to December 2007 in our institution, with a focus on both maternal and neonatal outcomes, as compared to no analgesia. Methods Parturients over 35 weeks of gestational age who received fentanyl iv-PCA (iv-PCA group) or no analgesia (control group) during labor were enrolled. The former group received iv-PCA through a pump programmed to give a loading dose of 0.05 mg fentanyl, followed by bolus injection of 0.02 mg fentanyl, with a lock-out interval of 5 min. This analgesia was initiated at the parturient's request and was discontinued before the second stage of labor, to ensure neonatal safety. During labor, both maternal and fetal heart rates, maternal pulse oximeter oxygen saturation (SpO ₂), respiratory rate, and sedation and nausea scores were continuously monitored, and the neonatal outcomes including umbilical arterial pH, Apgar scores, and other parameters were recorded. Results The data of 129 of the 143 parturients who received fentanyl iv-PCA were analyzed, while 697 parturients delivered without any analgesia during the 3-year study period. While iv-PCA prolonged the duration of labor and increased oxytocin use, no obvious maternal or neonatal complications of fentanyl use were recorded. Except for the significantly lower rate of emergency cesarean section in the iv-PCA group, both the maternal and neonatal outcomes were comparable between the groups. Conclusions As compared to no analgesia, fentanyl iv-PCA appears to be safe and clinically acceptable as analgesia during labor, particularly in nulliparous women. © 2011 Japanese Society of Anesthesiologists.</p>

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Fetal growth and gestational hypertension in women classified as gestational diabetes mellitus defined by the new consensus criteria only

Matsumoto Tadashi, Miyakoshi Kei, Minegishi Kazuhiro, Tanaka Mamoru, Yoshimura Yasunori

Acta Obstetricia et Gynecologica Scandinavica 91 ( 2 ) 272 - 273 2012.02

ISSN  0001-6349

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Dreaming of fetal ICU

Tanaka Mamoru

Journal of Medical Ultrasonics 38 ( 2 ) 63 - 64 2011.04

ISSN  1346-4523

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Final diagnosis in patients with congenital cystic lung disease detected by fetal ultrasonography

Kuratsuji Gen, Hokuto Isamu, Higuchi Masataka, Koinuma Goro, Morikawa Yasuhide, Hoshino Ken, Tanaka Mamoru, Miyakoshi Kei, Ikeda Kazushige

Pediatrics International 53 ( 1 ) 131 - 132 2011.02

ISSN  1328-8067

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Pancreatic β-cell function in women with gestational diabetes mellitus defined by new consensus criteria

Miyakoshi Kei, Saisho Yoshifumi, Tanaka Mamoru, Shimada Akira, Itoh Hiroshi, Yoshimura Yasunori

Diabetes Care 34 ( 1 )  2011.01

ISSN  0149-5992

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Midkine, a Heparin-Binding Growth Factor, Selectively Stimulates Proliferation of Definitive Zone Cells of the Human Fetal Adrenal Gland

Ishimoto, H. Muench, M. O. Higuchi, T. Minegishi, K.TANAKA MAMORUYoshimura, Y. Jaffe, R. B.

J Clin Endocrinol Metab 91 ( 10 ) 4050-4056 2006.08

Research paper (scientific journal), Joint Work, Accepted

Differential zonal expression and adrenocorticotropin regulation of secreted protein acidic and rich in cysteine (SPARC), a matricellular protein, in the midgestation human fetal adrenal gland: implications for adrenal development

Ishimoto, H. Ginzinger, D. G. Matsumoto, T. Hattori, Y. Furuya, M. Minegishi, K.TANAKA MAMORUYoshimura, Y. Jaffe, R. B.

J Clin Endocrinol Metab 91 ( 8 ) 3208-3214 2006.08

Research paper (scientific journal), Joint Work, Accepted

Prenatal diagnosis of hemifacial microsomia by magnetic resonance imaging

Hattori, Y. TANAKA MAMORU Matsumoto, T. Uehara, K. Ueno, K. Miwegishi, K. Ishimoto, H. Miyakoshi, K. Yoshimura, Y.

J Perinat Med 33 ( 1 ) 69-71 2005.01

Research paper (scientific journal), Joint Work, Accepted

H1FOO Is Coupled to the Initiation of Oocytic Growth.

TANAKA MAMORUKihara, M. Hennebold, J. D. Eppig, J. J. Viveiros, M. M. Emery, B. R. Carrell, D. T. Kirkman, N. J. Meczekalski, B. Zhou, J. Bondy, C. A. Becker, M. Schultz, R. M. Misteli, T. De La Fuente, R. King, G. J. Adashi, E. Y.

Biol Reprod 72 ( 1 ) 135-142 2005.01

Research paper (scientific journal), Joint Work, Accepted

Absent inner dynein arms in a fetus with familial hydrocephalus-situs abnormality

Kosaki, K. Ikeda, K. Miyakoshi, K. Ueno, M. Kosaki, R. Takahashi, D. Tanaka, M. Torikata, C. Yoshimura, Y. Takahashi, T.

Am J Med Genet 129 ( 3 ) 308-311 2004.09

Research paper (scientific journal), Joint Work

Pulmonary Hypoplasia: Prediction with Use of Ratio of MR Imaging-measured Fetal Lung Volume to US-estimated Fetal Body Weight

Tanigaki, S. Miyakoshi, K. Tanaka, M. Hattori, Y. Matsumoto, T. Ueno, K. Uehara, K. Nishimura, O. Minegishi, K. Ishimoto, H. Shinmoto, H. Ikeda, K. Yoshimura, Y.

Radiology 232 ( 3 ) 767-772 2004.09

Research paper (scientific journal), Joint Work, Accepted

Hypertensive disorders in Japanese women with gestational glucose intolerance

Miyakoshi, K. Tanaka, M. Matsumoto, T. Hattori, Y. Ueno, K. Teranishi, T. Minegishi, K. Ishimoto, H. Shimada, A. Yoshimura, Y.

Diabetes Res Clin Pract 64 ( 3 ) 201-205 2004.06

Research paper (scientific journal), Joint Work, Accepted

Rapid replacement of somatic linker histones with the oocyte-specific linker histone H1foo in nuclear transfer

Teranishi, T. TANAKA MAMORU Kimoto, S. Ono, Y. Miyakoshi, K. Kono, T. Yoshimura, Y.

Dev Biol 266 ( 1 ) 76-86 2004.02

Research paper (scientific journal), Joint Work, Accepted